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Disseminated Mycobacterium avium complex (MAC) infection occurs in 30% of AIDS patients over the course of the disease, and it is the third most common opportunistic disease, after Pneumocystis carinii pneumonia mycobacterium avium complex, MAC, mycobacteria avium (PCP) and Kaposi's sarcoma. The organisms are ubiquitous in the environment--found in soil, water, and in a variety of animals and foods. Mycobacterium Avium Complex is ingested or inhaled, and is established in lungs.
The risk of developing disseminated MAC disease is greatest for patients with CD4 counts below 50-75 cells/L and in those who have had a prior opportunistic infection.
Clinical Manifestations of Disseminated Mycobacterium Avium Complex DiseaseMost patients with MAC disease have disseminated multiorgan involvement. The most frequent symptoms are fever, night sweats, weight loss, wasting, weight loss, fatigue, diarrhea, and abdominal pain.
Physical findings include hepatomegaly, splenomegaly, and intra-abdominal lymphadenopathy (demonstrated by x-ray). Peripheral lymphadenopathy is uncommon.
Other symptoms and laboratory mycobacterium avium complex, MAC, mycobacteria avium abnormalities reflect local sites of involvement such as pneumonitis, pericarditis, osteomyelitis, skin lesions, soft tissue abscesses, or central Mycobacterium Avium Complex MAC nervous system lesions; localized disease is uncommon (ie, disseminated disease is more common).
The most frequent laboratory abnormalities are anemia, which is usually severe (hematocrit <30) or out of proportion to that expected with other underlying conditions or medications such as ZDV, hyperalbuminemia, and elevated alkaline phosphatase.
Diagnosis of Mycobacterium Avium Complex Disease
Diagnosis is based on recovery of MAC from blood (with lysis centrifugation) or bone marrow cultures. Recovery of MAC from other body fluids or tissue, such as cerebrospinal fluid or biopsy samples.